Provider Demographics
NPI:1720690597
Name:FUSNER, STACY M (DNP, APRN, CNP)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:M
Last Name:FUSNER
Suffix:
Gender:F
Credentials:DNP, APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2908
Mailing Address - Country:US
Mailing Address - Phone:740-891-1288
Mailing Address - Fax:740-487-4716
Practice Address - Street 1:1128 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2908
Practice Address - Country:US
Practice Address - Phone:740-487-4717
Practice Address - Fax:740-487-4716
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0027413363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily